Field Notes

Fruit and Veggie Prescriptions Encourage
Healthful Eating in Children

A new study shows that a fruit and vegetable prescription program can improve access to healthful foods for underserved children. The program, which was implemented in Flint, Michigan, could be replicated in other areas to address food insecurity in children.

In August 2015, the Hurley Children’s Center-Sumathi Mukkamala Children’s Center, a residency training pediatric clinic associated with the Michigan State University College of Human Medicine, relocated to the second floor of the downtown Flint Farmers’ Market. Immediately following this move, the clinic and the farmers’ market created a program to encourage families to shop at the farmers’ market by giving pediatric patients $15 prescriptions for fresh fruits and vegetables that can be redeemed at the market.

Flint is considered a food desert because it features a limited number of full-service grocery stores within city limits. About 60% of the city’s kids live in poverty, and many children don’t consume enough nutrient-dense foods while also eating too many poor-quality, calorie-dense foods.

“Fruit and vegetable intake tracks from childhood to adulthood, making it important for health care professionals to guide children towards healthy eating early on,” says lead researcher Amy Saxe-Custack, PhD, an assistant professor at Michigan State University and nutrition director of the Michigan State University-Hurley Children’s Hospital Pediatric Public Health Initiative. “We need to consider not only nutrition education but also barriers to access and affordability of fresh fruits and vegetables, particularly in underserved areas. The prescription program is a first step to introducing fresh, high-quality produce to children.”

Saxe-Custack recently presented results from the new study at the American Society for Nutrition’s annual meeting.

Through interviews, the researchers found that caregivers whose children received a fruit and vegetable prescription from their pediatrician were significantly more likely to shop at the farmers’ market than were those who didn’t receive a prescription. Caregivers also perceived the program as effective in improving food security, food access, and dietary patterns of children.

“The caregivers shared their heartfelt appreciation for the physicians and medical staff who introduced the prescriptions,” Saxe-Custack says. “Some talked about how they enjoy visiting the farmers’ market with their kids and guiding the children to use the prescriptions for their favorite fruits and vegetables. Others described how they hold on to the prescriptions until they reach $30 to $40 and redeem them at the market when food dollars are limited.”

The researchers recently received funding through Michigan Health Endowment Fund to expand the prescription program in Flint and evaluate its impact. With this funding, they will partner with Flint Fresh Mobile Market and allow families to redeem their prescriptions at either the Flint Farmers’ Market or at Flint Fresh Mobile Market, which includes online or telephone ordering of locally grown produce boxes delivered directly to people who live or work in Flint. This expansion will help the researchers to create a model program that may be replicated in other areas.

— Source: American Society for Nutrition

Crystal Structure Shows How Curcumin Impairs Cancer

Through X-ray crystallography and kinase-inhibitor specificity profiling, University of California (UC) San Diego School of Medicine researchers, in collaboration with researchers at Peking University and Zhejiang University, reveal that curcumin, a naturally occurring chemical compound found in the spice turmeric, binds to the kinase enzyme dual-specificity tyrosine-regulated kinase 2 (DYRK2) at the atomic level. This previously unreported biochemical interaction of curcumin leads to inhibition of DYRK2 that impairs cell proliferation and reduces cancer burden.

But before turning to curcumin or turmeric supplements, Sourav Banerjee, PhD, a UC San Diego School of Medicine postdoctoral scholar, cautions that curcumin alone may not be the answer.

“In general, curcumin is expelled from the body quite fast,” Banerjee says. “For curcumin to be an effective drug, it needs to be modified to enter the bloodstream and stay in the body long enough to target the cancer. Owing to various chemical drawbacks, curcumin on its own may not be sufficient to completely reverse cancer in human patients.”

As recently published in the Proceedings of the National Academy of Sciences, Banerjee and colleagues report that curcumin binds to and inhibits DYRK2 leading to the impediment of the proteasome—the cellular protein machinery that destroys unneeded or damaged proteins in cells—which in turn reduces cancer in mice.

“Although curcumin has been studied for more than 250 years and its anticancer properties have been previously reported, no other group has reported a cocrystal structure of curcumin bound to a protein kinase target until now,” according to Banerjee, lead study author.

“The enzyme kinases IKK and GSK3 were thought to be the prime curcumin-targets that lead to anticancer effects but the cocrystal structure of curcumin with DYRK2 along with a 140-panel kinase inhibitor profiling reveal that curcumin binds strongly to the active site of DYRK2, inhibiting it at a level that is 500 times more potent than IKK or GSK3.”

Banerjee and team have been looking for regulators of proteasomes to inhibit tumor formation by proteasome-addicted cancers like triple-negative breast cancer and the plasma cell malignancy called multiple myeloma.

Using biochemical mouse cancer models and cellular models, the team found that curcumin is a selective inhibitor of DYRK2 and that this novel molecular target has promising anticancer potential for both chemosensitive and proteasome inhibitor resistant/adapted cancers.

“Our results reveal an unexpected role of curcumin in DYRK2-proteasome inhibition and provide a proof of concept that pharmacological manipulation of proteasome regulators may offer new opportunities for hard-to-treat triple-negative breast cancer and multiple myeloma treatment,” according to Jack E. Dixon, PhD, of UC San Diego, who was cosenior author with Zhejiang University’s Xing Guo, PhD. “Our primary focus is to develop a chemical compound that can target DYRK2 in patients with these cancers.”